晚期心力衰竭中的缺血病源:来自HELP-HF注册表的洞察力
Alessandro Villaschi1, Matteo Pagnesi2, Davide Stolfo3
1Cardio Center, Humanitas Research Hospital IRCCS, Rozzano-Milan, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy.
The American journal of cardiology
|August 10, 2023
概括
缺血性心力衰竭 (HF) 在患有晚期心力衰竭的患者中很常见,无论2018年心力衰竭协会的标准如何. 缺血病的病因显著增加了晚期HF患者死亡和住院的风险.
科学领域:
- 心脏病学 心脏病学
- 心脏衰竭研究研究
背景情况:
- 晚期心力衰竭 (HF) 诊断依赖于特定的标准.
- 晚期肝炎中缺血病因的预后影响尚不清楚.
研究的目的:
- 调查晚期心力衰竭 (HF) 患者缺血病病因的预后意义.
- 分析缺血性HF对死亡率和住院率的影响.
主要方法:
- 分析了来自HELP-HF注册表的患者.
- 基于缺血病因和欧洲心脏病学会2018年心力衰竭协会 (HFA-ESC) 的高级心力衰竭标准的分层.
- 主要终点:综合所有原因死亡和1年后HF住院.
主要成果:
- 缺血病因是高级 (46.1%) 和非高级HF患者 (42.4%) 的HF的主要原因.
- 缺血病患者的主要终点 (HR 1.31) 和全因死亡率 (HR 1.37) 的风险显著增加.
- 这种增加的风险在先进的 (HR 1.50) 和非先进的HF亚组中一致,主要是由心血管死亡驱动的.
结论:
- 缺血病因是导致高血压的常见原因,即使在符合高级高血压标准的患者中也是如此.
- 缺血性心力衰竭与更糟糕的预后有关,包括增加死亡率和住院治疗,无论是晚期还是晚期的HF患者.
相关概念视频
Pathophysiology of Heart Failure
1.6K
Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
1.6K
Heart Failure IV: Classification and Diagnostic Evaluation
19
Heart failure can be classified in various ways, with the most common classifications based on physical activity limitations, disease progression, severity, and treatment strategies.The Functional Classification of Heart Failure divides patients into four categories based on physical activity limitation due to symptom burden.Class I: Patients in this class have cardiac disease but no physical activity limitations. Ordinary activities like walking, climbing stairs, or routine tasks do not cause...
19
Heart Failure I: Introduction
16
Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...
16
Heart Failure II: Pathophysiology
15
Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
15
Heart Failure V: Medical Management
13
Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
13
Heart Failure III: Clinical Manifestations
23
Heart failure (HF) manifests primarily as dyspnea, fatigue, and fluid retention, resulting in peripheral and pulmonary edema. Symptoms may vary depending on which ventricle is more affected, left or right.Left-Sided Heart FailureAlso known as left ventricular failure, this condition results from the left ventricle's inability to fill or eject sufficient blood into the systemic circulation. It leads to pulmonary congestion, which occurs when the left ventricle fails to eject blood effectively...
23


